Individual provider Active NPI

Jaslyn Robb Seeley

  • Occupational Therapist
  • Douglas, WY
National Provider Identifier
1013647403
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-1641LL Issued in WY
Practice address
111 S 5TH St
Douglas, WY 82633-2434
Phone
(307) 358-9464
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-1641LL WY Primary

Addresses

Primary practice location

111 S 5TH St
Douglas, WY 82633-2434

Mailing address

PO Box 1790
Douglas, WY 82633-1790
Phone (307) 358-9464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922003275 WY Practitioner - Occupational Therapist in Private Practice 9739564022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
212 Degrees LLCGroup PAC ID 3072648468, 12 clinicians

Practice addresses (Care Compare)

1103 E Boxelder Rd
Suite U
Gillette, WY 82718-5582
Phone (307) 686-8177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-1641LLWYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
212 Degrees, LLC Occupational Therapist CurrentSince Sep 19, 2023 Accepting new patients
Memorial Hospital of Converse County PastSince Aug 1, 2022 Accepting new patients

Locations

1103 E Boxelder Rd
Ste U
Gillette, WY 82718
Phone (307) 363-5801

219 W Main St
Newcastle, WY 82701
Phone (307) 363-5930

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1013647403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331790",
            "telephone_number": "307-358-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELEY",
        "first_name": "JASLYN",
        "middle_name": "ROBB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WY",
            "license": "OT-1641LL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.